新型降糖药物的应用：二肽基肽酶-4抑制剂、胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白2抑制剂

[Application of new glucose lowering drugs: DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors].

作者信息

Verburg Arianne F E, van den Donk Maureen, Wiersma Tjerk

机构信息

Nederlands Huisartsen Genootschap, Utrecht.

Contact: A. Verburg (

出版信息

Ned Tijdschr Geneeskd. 2019 Jan 14;163:D2962.

PMID:30676706

Abstract

A comprehensive review of the literature on DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors has resulted in small changes to the medication roadmap of the type 2 diabetes mellitus standard of the Dutch College of General Practitioners. SGLT-2 inhibitors and GLP-1 receptor agonists may have benefits related to cardiovascular outcomes in patients with high cardiovascular risk, especially in those who have experienced a cardiovascular event. However, ascribing effectiveness related to cardiovascular outcomes on the basis of a single cardiovascular safety trial is premature. Metformin, sulfonylurea derivatives and insulin are still the cornerstone of type 2 diabetes mellitus treatment in primary care.

摘要

对二肽基肽酶-4（DPP-4）抑制剂、胰高血糖素样肽-1（GLP-1）受体激动剂和钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂的文献进行全面综述后，荷兰全科医生学院2型糖尿病标准的用药路线图有了一些小的变化。SGLT-2抑制剂和GLP-1受体激动剂可能对心血管风险高的患者的心血管结局有益，尤其是那些经历过心血管事件的患者。然而，仅基于一项心血管安全性试验就将有效性归因于心血管结局还为时过早。二甲双胍、磺脲类衍生物和胰岛素仍然是基层医疗中2型糖尿病治疗的基石。